A Feminist Intervention That Hurt Women: Biological Differences,Ergonomics,and Occupational Health: Une intervention féministe qui a nui aux femmes: différences biologiques,égalité,ergonomie et santé au travail

Abstract

The University of Québec in Montréal has agreements with trade unions providing access to university resources. Researchers involved in this program worked in partnership with union women’s and health and safety committees for more than twenty years. Not all studies succeeded in improving women’s working conditions. One joint project involved observational studies of tasks done by health-care workers, complemented by interviews and questionnaires. We found that task assignments, movements, postures, and work-related musculoskeletal disorders varied by gender/sex and made recommendations for change. However, issues of pay equity, spending on health care, and contracting-out of “ancillary work” were salient. Researchers learned that in the absence of changes in power relationships in the workplace, women may be disadvantaged by denial as well as by exaggeration of female–male differences. Men may also be at risk when their gender is invisible. We suggest some feminist approaches to workplace solutions and some pathways for research.

Résumé

L'Université du Québec à Montréal a signé avec des centrales syndicales des ententes leur donnant un accès à des ressources universitaires. Des chercheures ont travaillé en partenariat avec des comités syndicaux de condition des femmes et de santé-sécurité au travail pendant plus de 25 ans, mais ce ne sont pas toutes les études qui ont abouti à des améliorations. Un projet concernait des observations du travail d'employé.e.s du secteur de la santé, dont les tâches, mouvements, et postures variaient selon le genre/sexe. Nous avons recommandé des transformations, mais des enjeux d'équité salariale, de coûts et de sous-traitance y ont fait obstacle. Les chercheures ont appris qu'en l'absence de transformation des rapports de pouvoir au travail, le déni des différences hommes-femmes, autant que leur exagération, peut désavantager les travailleuses (et les travailleurs). Nous suggérons des approches féministes aux solutions pour le milieu de travail, ainsi que des pistes de recherche.

Keywords

occupational health gender sex ergonomics health-care work employment equity

Introduction

In the mid-1970s, as a biology professor and a member of my union women’s committee, I was part of a movement that sought to diminish the female–male wage gap in Québec by raising wages in women’s jobs and by eliminating gender distinctions in job assignments. We targeted jobs that had previously been designated specifically as female or male. For example, originally, women cleaning hospital rooms were assigned to “cleaning—women.” They dusted, cleaned toilets, and emptied wastebaskets. Men were assigned to “cleaning—men” and mopped, polished floors, and pushed vacuum cleaners. After explicit sex discrimination in hiring became illegal in the 1960s, the job titles were changed respectively to “cleaning (light work)” and “cleaning (heavy work)” with no change in job content. The “heavy work” (HW) jobs were still almost exclusively done by men and received higher pay than “light work” (LW), done almost exclusively by women. Struggles within the union and with the employer (the province of Québec) culminated in the abolition of the pay differential in the 1980s, but the separate job titles persisted.

In 1976, my employer, the University of Québec at Montréal (UQAM), signed an agreement with the three largest Québec labor unions, providing them with human and economic resources for training and research.^1,2 In the context of this agreement, the Confédération des syndicats nationaux (CSN) union in the 1990s asked me to contribute to training sessions in ergonomics for both cleaners and health-care aides (HCAs). Later, the CSN women’s committee requested ergonomics research on the gendered distribution of tasks and observable work activity in those jobs. By that time, I was no longer a member of the union women’s committee but I was quite interested to reexamine this job from a scientific point of view. I describe here some issues arising from three studies with the CSN’s women’s committee and its health and safety committee, carried out between 1994 and 2008.

A note on terminology: Using the example of osteoporosis, biologist Anne Fausto-Sterling has explained why it is difficult to ascribe real-life phenomena dichotomously as either due to socially produced gender or to biological sex, since gender and sex interact in many different ways to produce such phenomena. Osteoporosis is a result of women’s hormone-influenced anatomy and physiology, yes, but also our activity level and diet, which are in turn affected by (for example) social standards, occupational segregation, and domestic roles. Fausto-Sterling’s discussion can be applied to various workplace phenomena such as lifting weights; it is impossible to separate social from biological determinants of lifting strength.³ I will therefore refer to gender/sex (g/s) throughout the following description of job assignments and health implications.

The Cleaners

Our first study of hospital cleaners took place in 1994–1995.^4,5 In Québec, hospitals are publicly owned and hospital cleaners are government employees, unionized and relatively well-paid as cleaners’ pay goes. The CSN organized a series of training sessions as part of a larger mobilization of hospital workers against proposed outsourcing and job cuts. Our part of the training concentrated on biological and ergonomic risks to cleaners’ health. However, from their comments and questions, we became aware of social and organizational aspects of their work. I was especially struck by the terrible communication between cleaners and nursing staff, which made it hard for cleaners to organize their work and protect their health. For example, cleaners were not allowed to access any information on patient health, so they were quite scared of contagion when they went into patients’ rooms, especially when they saw others taking special precautions. I also heard a lot about how cleaners and even cleaning managers were excluded from consultations on room and furniture design, despite critical effects on the difficulty of cleaning. Cleaners shocked me with reports of insults from families of hospital patients and others who had no idea of how little power the cleaners had over the level of dirt in the hospital. The cleaners in the union were happy to collaborate in our study and “North Hospital” accepted our presence.

The only source of funds for ergonomics research was then in social sciences, so we oriented our grant application toward questions of gender and sex and their influence on the division of assigned tasks and actual work activity. We received enough money to hire two ergonomics graduate students to distribute a short questionnaire and to observe the cleaners’ work activity (25.5 h for LW and 34.75 h for HW). The observations were performed over a period of weeks, during day and evening shifts, so that all aspects of work could be sampled.⁴ After the first observations, I asked the students to describe the work and give me their first impressions. I was concerned that they not allow the research hypothesis to bias their observations, so I wanted to develop an observation grid as quickly as possible. I was reassured although quite surprised to find that the students (both women) had completely forgotten that g/s was part of the research hypothesis and had focused on understanding and improving the organizational and material conditions of all cleaners. This invisibility of g/s in the workplace was our first finding, repeated many times since and also mentioned to us by other researchers, for example in a series of university discussions on ergonomics and gender (see later).⁶ Even to experienced researchers interested in the subject, g/s is rarely salient to those observing work. Workers and managers also say they find it strange to discuss g/s in relation to their work.

Our second finding was a strict division of assigned tasks by job title as well as an addition of tasks associated with workers’ g/s. Such g/s differences in cleaners’ tasks have also been reported in the United States.⁷ Each office, hospital room, and common area was cleaned twice: once by a man assigned to HW and once by a woman assigned to LW. HW consisted in theory of mopping and vacuuming floors, washing large surfaces, and doing any work requiring use of a ladder. In some hospitals, workers had been told, erroneously, that it was illegal for a woman to use a ladder or that insurance would not cover costs if a woman had an accident on a ladder. In practice, men assigned to HW were asked by the largely female nursing staff to do many tasks perceived as male, from pushing heavy objects to calming and even restraining obstreperous psychiatric patients.

LW, on the other hand, consisted of cleaning and dusting small objects and anything that could be reached from a standing, kneeling, or stretching position, such as bedside tables, medical equipment, and toilets. LW cleaners were also responsible for waste disposal, emptying wastebaskets and picking up waste. LW was underestimated by the computer program used to assign tasks and work areas; LW tasks were more often omitted from the inventories of tasks used to establish staffing, so that LW cleaners were forced to hurry to finish their assigned tasks.

G/s stereotypes resulted in conflicts over work assignments. Was it OK for a woman cleaning a bathroom mirror to use a ladder or should she stand on the sink or toilet even though she risked falling? Should HW or LW (or nurses) clean up spilled urine, given that urine is associated with toilets (LW), but also with patient care and with floor cleaning (HW)?

Our third finding was that the division of tasks corresponded to a g/s difference in work activity and therefore to g/s-based health risks. The postures of those doing LW were more varied and involved more extreme postures than in HW. LW cleaners stooped, stretched, and bent over more often, while HW involved standing, walking, and pushing mops and polishers. The movements per minute in LW were faster than in HW, but movement amplitude was smaller. Surprisingly, though, there was overlap in the weights manipulated. Although, on the average, HW manipulated heavier weights, some wastebaskets and furniture lifted by LW were heavier than anything lifted by HW.⁴

Our fourth finding was that the division of job titles and work activity corresponded to a g/s difference in reported musculoskeletal discomfort. A short questionnaire with a body map was completed by nineteen workers (nine female, ten male); the women reported significantly more neck/shoulder but significantly less back fatigue than the men.

Our report made eighty-four recommendations for improvements to the job design, procedures, organization, communications, purchasing procedures, and equipment. One of the eighty-four involved in examining the HW/LW distinction to see whether it was necessary and appropriate. The union transmitted the report to the hospital as well as to the joint union-employer safety organization (ASSTSAS) and eventually to government. At the union’s suggestion, we published our findings in an article in the ASSTSAS magazine.

During the period 1996–2007, three changes happened, two of which were probably related to our report. First, a government pay equity examination raised the pay of LW so that it exceeded pay for HW; they had examined our report on job content of LW. Next, several hospitals merged the HW and LW job titles, occasionally citing our report. Usually, the merged job title was called “heavy work.” The number of workers assigned to LW was cut in half while HW remained constant. Finally, epidemics of nosocomial illnesses such as Clostridium difficile broke out in many hospitals, leading to concern with hygiene and slowing the trend to job cuts and outsourcing in hospital cleaning.

In 2007, the CSN women’s committee asked us to look again at the cleaning job. They wanted to know whether to support the trend to merging LW and HW. In “Central Hospital,” unionized women were blocking the merger, citing unwillingness to do certain tasks in HW, and saying that they feared for their jobs. This hospital did not allow us access, but we were able to return to the original hospital (“North Hospital”) and enter another one (“South Hospital”) in order to examine task assignments and work activity among women and men in the merged job title.⁸

We found that the number and proportion of women cleaners had dropped sharply in North Hospital. The women in the merged jobs were much less senior than in 1994–1995 and younger than the men. Our observations showed us that the work activity of women and men in the merged job title still differed, with men spending twice as much time on mopping as women and women spending twice as much time cleaning toilets as men. In interviews, we were told that some men objected on principle to cleaning toilets, saying that they never did this task at home. The g/s differences in pain and fatigue reports showed most of the same tendencies as in 1994–1995, although the male–female differences were no longer statistically significant. A significant increase in lower limb fatigue appeared, especially among men; this may have been related to the intervening job cuts and consequent larger areas to be cleaned. Finally, only about a third of the environmental changes we recommended had been carried out over the intervening years and many risks and difficulties persisted. A close examination of some tasks in both North and South Hospitals showed that there were specific assignments refused by all women and some men, such as trash compacting, which involved exceptionally heavy weights as well as general stinkiness. In 2012, a student examined this job more closely with a view to making it less dangerous.⁸ Management neither paid for this study nor committed to making the job accessible to smaller, less muscular workers. Given growing austerity in the health-care sector, the local union had many priorities other than facilitating entry for women.

Thus, although our studies had probably resulted in higher pay for women, they produced marginal effects on the g/s segregation of tasks and resulting discomfort. Most seriously, the subsequent merging of task assignments appeared to have had a negative effect on hiring women and/or on women’s ability to survive in cleaning. We had to wonder what to say to the women in “Central Hospital” who were asking me and the union health and safety people to say straight out that women were biologically unable to do HW.

The HCAs

Our failure to improve cleaners’ health was especially disappointing when combined with the results from a study of health-care aides that we had done between the two studies of cleaners. In 2000, the union asked us to examine another case of LW and HW.⁹ HCA, like cleaners, had previously had separate job titles for women and men that were redesignated as LW and HW with more pay for men and for HW. The LW and HW job titles were merged in the 1979–1982 collective agreement. Both women and men HCAs strongly expressed concern about the merger during the 1990s ergonomics training sessions. Both maintained that women were not strong enough to move patients. They said that women HCAs in the merged job titles were injuring themselves and men were being overworked, doing extra lifting to compensate for their weaker colleagues. Women and men agreed that the nurses would always ask men, never women, to help them with physically demanding tasks.Older men especially expressed fear of back pain problems from the extra lifting. We heard no dissent in the sessions; men and women agreed that men were being overworked and that women risked injury because of the job merger.

According to the HCAs, some hospital departments had tried to ensure that one man at least was hired on each floor, but this practice was judged discriminatory and where it persisted, it was hidden. Tribunals enforced identical job requirements for women and men in this job. After our sessions, the women’s committee and health and safety committee of the union asked for a study with a view to reducing the barriers to full g/s integration in HCA work.

We first visited fifteen hospitals to get an overview of how the job title merger had gone. Management and local unions were unanimous in saying that the jobs had been successfully merged and that women and men did exactly the same tasks. However, all but two hospitals refused to take part in our study, saying “Let sleeping dogs lie” (Ne pas réveiller le chat qui dort). When pushed, both unions and management explained that the merger had been painful and controversial and that they were afraid of reintroducing an issue that would poison work relations among male and female HCAs.

Those two hospitals accepted on an explicit condition that our study would primarily deal with the reduction of work-related injuries, a major risk among HCAs.^9,10 We performed interviews and about a hundred hours of observations in four departments employing a 60 percent female HCA work force. We observed workers with several years of seniority. HCAs in a third hospital helped by responding to a short questionnaire listing the various physical components of their work; they rated the difficulty of each operation (turn patient in bed, make a bed . . .). On average, female respondents rated all operations as significantly more physically demanding than did males. We used the answers to construct an observation grid for operations in North and South Hospitals. All observed operations were classed as “very physically demanding,” “physically demanding,” or “not demanding,” based on the workers’ answers. For each physically demanding operation observed, the observer noted whether the physical aspects were shared with a colleague and the gender of the observed worker and colleague.

The results surprised us. We found that the HCAs shared most of the physical demands of their work; 45 percent of all physical operations and 62 percent of “demanding” operations were done in pairs. We found that the women performed 30 percent more physical operations per hour and that they performed them alone slightly more often than did men. They did 15 percent more “demanding” operations per hour and performed these alone slightly less often than men. Most unexpectedly, nurses were four times more likely to ask for help from women HCAs as from men, while men HCAs were more likely than women to ask for help from a nurse. Very occasionally, three times during the hundred hours of observations, we did observe that a man was asked to perform a particularly dangerous task explicitly because of his g/s: two tasks involved lifting morbidly obese patients and one involved restraining an aggressive patient. One man refused to do the requested lift alone, insisting on help from the women present. We did not observe any similar demands placed on women because of their g/s. In one department, we were told that one woman HCA but no male HCA refused to lift heavy loads; the woman acknowledged to us that she refused because she was an older woman. In the same department, we were told that one male HCA but no female HCAs systematically avoided lifts without citing a reason.

We validated these results with two ergonomists familiar with hospital work and then presented them to workers and supervisors. The discussions with workers, held in gender-mixed groups, became somewhat acrimonious and uncomfortable, with both men and women disputing our results on the frequency of physically demanding tasks done by women. Nevertheless, some women later told us privately that they believed our data. Two supervisors also said that our report squared with their observations. The local union showed no interest in the results, and the local union president said he did not believe our numbers.

Nevertheless, the CSN national women’s committee and health and safety committee were interested in the results and produced a brochure based on these and other studies, intended for training. The brochure dealt with male–female relations at work as a factor in occupational health and safety.¹¹ Unfortunately, the training initiative was abandoned after the first (gender-mixed) training session gave rise to unpleasant exchanges and many off-topic remarks and speeches.

Six months after our final report on HCAs was approved, I happened to cross the path of “James,” one of the two ergonomists who had approved it. I mentioned that I had just published a book on women’s occupational health and safety and he replied, “Why a book on women? Men’s jobs, women’s job’s, there’s no difference. A woman health care aide, a man health care aide, it’s the same job.” I reminded him that the report he had approved had said otherwise, but he was unconvinced.

Policy Implications

Our experiences during these two studies lead me to some suggestions for policy on sex and gender in relation to ergonomics and occupational health.

Keeping G/S in Mind

During a number of our studies, most workers, union respondents, and employer representatives, as well as some collaborators and scientific colleagues, genuinely did not see the point of our questions and research results relating to g/s. Like “James,” they persisted in regarding g/s as irrelevant even after extensive demonstrations. One ergonomist who had trained in our research center and was working for a government health and safety association told us that his organization had never had any kind of request for intervention that involved g/s. Moreover, as mentioned, we ourselves were not immune to this blindness despite the fact that we had written countless grant applications and scientific publications on g/s and occupational health. I think four phenomena contribute to g/s blindness in ergonomic interventions.

First, paradoxically, keeping blind to gender may be a survival strategy for women workers.^12,13 For them, being visible as a woman can be an obstacle to a successful career, particularly in nontraditional jobs or task assignments. We have recounted elsewhere the story of a communications technician who, while on sick leave after having been raped by another worker on a job site during work time, denied in an interview with researchers that women had any particular difficulties at her job, where almost all workers were men.¹⁴ Her female colleagues, who knew about the incident, persisted in similar denials, despite a preferential attrition rate for women workers of over 90 percent during the preceding three-year period. Would the attack victim be able to go back to her job if she did not forget about the danger? Would her female colleagues be able to face going to work every morning if they were constantly aware of g/s-based barriers? How would their male colleagues react if the women visibly identified as women? Women, like other discriminated groups, may be forced to see discriminatory behavior in the workplace as normal or at least acceptable.¹⁵

We would therefore alert unions and governments to the necessity of accompanying any attempts to support job desegregation with explicit concomitant programs to support and educate them and their colleagues about g/s in relation to health and safety. The numbers of women have to be monitored in these situations and any drop in numbers needs to be addressed. Levels of harassment should be monitored without the necessity for victims to make formal complaints, but avenues for complaints should also be established. We suggested this approach as a response to the question from Central Hospital about merging LW and HW jobs.

This suggestion of making g/s explicit in the workplace brings us to the second area of concern, that of potential confrontations in the workplace. When we started the study of HCAs, as mentioned, both management and unions referred to potential unpleasantness if g/s was brought up. They feared an uncomfortable atmosphere at work and pointed to difficulties and quarrels at the time job titles were merged. The failure of the brochure and of the attempts to discuss g/s at health and safety meetings showed that these fears were justified. Research needs to be done to develop appropriate training materials and techniques such as game-playing so that female and male workers (and managers) are supported during changes in gender dynamics and educated about the value of diverse talents for the success of work teams. This problem has also been identified in a report on the construction industry in the United States; the report points out that training does not work to support diversity unless there is also organizational change.¹⁶

A third problem faces both academics and those in the workplace: prudery. Tool belts may push women’s breasts into unwelcome prominence; women bus drivers may need bathroom accommodation during their menstrual periods. It is difficult to discuss biological g/s differences in detail without mentioning breast size, menstruation, sexual intimidation, pregnancy, or lactation, subjects with which many workers are ill at ease.

Scientists are no better. Angela Tate, an engineering student at Memorial University, has pointed out to us that biomechanical studies of human anatomy in relation to lifting are usually done on male cadavers and that no studies have been done on the relevance of women’s breast size. It is possible, for example, that women with large breasts may have trouble or risk injury while carrying boxes in front of them. My question about research into this area on the scientific exchange website ResearchGate elicited some puerile jokes but no actual research results. We have experienced similar problems with getting funding or finding venues for publication for research on the effects of cold exposure and other workplace conditions on perimenstrual dysfunction and on the biomechanics of physical operations during pregnancy.¹⁷ Therefore, we scientists lack knowledge on many points that would enable us to improve the fit between women’s bodies and task assignments. Such information on female-specific risks should be developed. Consultations need to include single-gender as well as mixed groups.

Finally, detecting the relevance of g/s in relation to occupational health and safety is hard for practitioners who try to improve specific jobs. Sociologists and epidemiologists who work on population-based data may easily observe g/s effects, but those who intervene in workplaces deal with individuals or small groups. Although on average, male cleaners may (or may not) be taller, stronger, less meticulous, or more assertive than women cleaners, individual cleaners usually do not differ strikingly from all their co-workers of the opposite g/s. Therefore, since ergonomists like “James” or myself observe individuals, we do not automatically become aware of g/s as a salient component of the workplace. On the other hand, our training makes us acutely aware of both “Joe’s” and “Mary’s” uncomfortable postures, fast speeds, and poor work environment. Solutions to the latter problems are much easier for us to find, as well. Material should be developed for training ergonomists in the implications of gender and sex for workplace design. We are currently collaborating with colleagues to develop French-language textbook materials on g/s and ergonomics.

G/S Division of Labor: A Good Thing for Women?

It can be argued that our 1994–1995 study of cleaners, undertaken at the initiative and with the support of the women’s committee of a progressive trade union, made life worse for women cleaners. It is also possible that the merger of job titles of HCAs made life worse for both women and men; the women seemed to overexert themselves in the face of criticism while the men were still exposed to specific risks in extreme situations. This is a very disappointing outcome after twenty years of university-union collaboration on g/s based research and intervention in occupational health.

I would suggest that this failure is at least partly due to the current context of labor relations in North America. Although union membership in Québec is relatively high at 39 percent for both women and men (cf. 11 percent in the United States),^18,19 the actual power of labor unions to effect change in concrete working conditions is quite limited. Despite management’s original acceptance in principle of our eighty-four recommendations to improve cleaners’ health in 1995, only about one third had been implemented thirteen years later. The merger of LW and HW, while proposed as a means to reduce exposures to repetitive movements, was in fact carried out in reaction against the pay equity initiative that had sharply raised the cost of hiring in LW.

Among fifty-eight presentations to a series of gender and ergonomics workshops held in Montréal, Québec, during 2008–2015, eight concerned physiological or biomechanical differences between women and men that were relevant to workplace or job design. For example, Plamondon’s research found that a small sample of experienced women materials handlers all had significantly less lifting strength than a comparable group of men, with no overlap between the sexes.²⁰ His study showed that the women lifted 15-kg boxes using different strategies from men. These findings were similar to those of Stevenson et al.²¹ showing that women could lift more weight if they had more leeway to choose lifting techniques and to influence the lifting environment. Plamondon suggested redesigning the task environments to allow women to lift in ways that were safer for them. He also suggested specifically lowering the weights to be lifted by women, a controversial idea.

A further eleven of the fifty-eight presentations dealt explicitly with integrating women into nontraditional situations. All concluded that there was resistance to making changes to the jobs in response to the presence of women, resulting in high attrition and occupational health risks. In the absence of a meaningful employer commitment to adapting job design, educating around harassment, and promoting collaboration in diverse teams and lacking support from the unions, we must conclude, sadly, that forcing desegregation may not be a good thing for women’s long-term economic or physical health. In this connection, it will be important to follow closely the effects of recent Québec government measures facilitating entry of women into construction jobs, without any visible accompanying measures to secure their retention.²²

Is G/S Analysis a Good Thing for Men?

Although men’s overall rates of occupational accidents and fatalities are higher than women’s,^23,24 men’s g/s is rarely examined in relation to occupational health and safety. In the HCA study, however, the gender of both men and women appeared to put each at risk. While the women felt forced to overcompensate for their perceived weakness, men were put at increased risk for rarer but particularly dangerous exposures. However, researchers in France and Sweden have pointed out that older men in physically demanding workplaces are sometimes allowed or encouraged to move to less demanding tasks, whether formally or informally; this does not appear to happen for women.^25,26 Since many exposures in women’s jobs are underrecognized, such adjustments are not available to women in g/s-segregated workplaces; older, injured women can be forced to take early retirement instead.²⁷ Also, we have sometimes seen men fear that if women enter their jobs, the women will occupy some slots previously reserved for ageing men, increasing risk to men. We think that special attention should be given to the use of g/s stereotypes to justify overexposure of men or women, as well as to s/g issues that arise as the work force ages.

Is Doing Research on Male–Female Biological Differences Compatible with Promoting Workplace Equality?

Just as some health science researchers have been less than delighted by the challenges of teasing out the genetic, social, legal, and policy implications of data on African-American health collected in a context where racism is a clear and present danger,²⁸ some worker friendly, feminist researchers have been justifiably reluctant to emphasis s/g differences in work-related biology. They correctly point out that, for many body dimensions and strength tests, within-sex differences exceed between-sex differences. They also say, very reasonably, that work is usually done in teams and that teammates generally work out the distribution of tasks in a way that builds on members diverse strengths and minimizes weakness.²⁹ I would suggest, however, that in a world where most biological research on occupational health, anatomy, physiology, and ergonomics has been done with male subjects, there may be hidden holes in the data and it could be dangerous to women to refuse to explore male–female differences. In addition, given the behavioral dynamics in groups of mixed s/g (or ethnicity, or color, or . . .), optimization of individual contributions may not happen spontaneously.

Some recent research results alert us to the possibility that at least some g/s differences may be vitally relevant to prevention of occupational disease and injury. Neurotoxic exposures may take somewhat different pathways in women and men,³⁰ repetitive tasks may be handled in somewhat different ways by female and male neuromuscular systems,³¹ and women doing the same tasks as men may be performing closer to their physiological limit.³² In my own and my colleagues’ studies of musculoskeletal effects of standing versus walking, there are legitimate questions about the methods used to consider the effects of g/s differences in body weight and stride length and their effects on feet and hip joints that also differ by g/s.³³ Also, I’m still curious about whether women with bigger breasts who lift weights in front of them at work are at increased risk for back pain problems and what solutions there could be.

Therefore, I would like to see more research on g/s differences in relation to work, but it needs to be carried out in close relation to worker and feminist advocacy. In other words, a safe space for such research needs to be established. For the last forty years, our research center has benefited from such a safe space due to the university-union agreement. However, the fact that our agreement is unique makes it quite vulnerable to neoliberal pressures to cut this budget item. I therefore recommend that unions and other community groups pressure publicly funded universities to create mechanisms that allow the groups to access academic resources at low cost with guaranteed input at all stages of the research process.

Footnotes

Acknowledgments

We thank the workers, union representatives, and administrators at the hospitals. We are grateful to Marie-France Benoit and Micheline Boucher of the Confederation of National Trade Unions for initiating the studies. Bénédicte Calvet, Céline Chatigny, Julie Courville, and Diane Elabidi also participated in data collection and discussions of the results. Karen Messing is a member of the knowledge transfer intervention team “Modeling an approach to gender-conscious participatory action oriented research and knowledge transfer” of the Institute for Gender and Health as well as the research team “Gender equity in occupational health” supported by the Fond de recherche du Québec—Société et Culture.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Author Biography

Karen Messing is a professor emerita of ergonomics at the CINBIOSE research center at the University of Québec in Montréal, Canada. Her research, done in collaboration with women’s groups and unions, applies gender-sensitive analysis to occupational health. She wrote One-Eyed Science: Occupational Health and Working Women (Temple, Philadelphia, 1998) and Pain and Prejudice: What Science Can Learn About Work from the People Who Do It (BTL, Toronto, 2014). She is a member of the research team “Gender equity in occupational health” supported by the Fond de recherche du Québec—Société et Culture and a principal investigator of the knowledge transfer intervention team “Modeling an approach to gender-conscious participatory action oriented research and knowledge transfer” of the Institute for Gender and Health.

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